Use of long-acting risperidone in psychiatric disorders: focus on efficacy, safety and cost–effectiveness

Abstract

Schizophrenia is a chronic disorder, usually necessitating lifelong treatment. Although atypical antipsychotic agents have improved outcomes in schizophrenia, their clinical potential remains limited by patients’ nonadherence to medication. Long-acting antipsychotics were developed in the 1960s to enhance treatment adherence and simplify the medication process. However, although conventional long-acting agents assure medication delivery, they are associated with similar side effects to their oral equivalents. The need for an agent combining the advantages of a long-acting formulation with those of an atypical antipsychotic was highlighted in 1997 by the American Psychiatric Association’s Practice Guideline for the Treatment of Patients with Schizophrenia. The first long-acting injectable atypical antipsychotic, long-acting risperidone (Risperdal^® Consta^®, Johnson & Johnson), has since been developed. This article discusses the efficacy, tolerability and cost–effectiveness of long-acting risperidone in schizophrenia and bipolar disorder patients, and suggests possibilities for how its role in clinical practice may change over the next 5 years.

Keywords::

• adherence
• antipsychotic
• bipolar disorder
• efficacy
• long-acting risperidone
• pharmacoeconomic
• pharmacokinetic
• remission
• schizophrenia
• tolerability

Acknowledgements

The author would like to thank F Gambling, Medicus International, for her editorial assistance. Ms Grambling’s editorial assistance was funded by Johnson & Johnson. All final editorial decisions and decisions regarding content were made by the author.

Financial & competing interests disclosure

S Keith has been a consultant for Bristol-Myers Squibb, Janssen Pharmaceutica, Novartis, Eli Lilly and Pfizer, and has received speaker’s honoraria from Pfizer and Janssen. Dr Keith has additionally received unrestricted educational grants for CME programs from AstraZeneca, Bristol-Myers Squibb, Cyberonics, Eli Lilly, Forest Therapeutics, GlaxoSmithKline, Janssen Pharmaceutica, Lundbeck, Merck & Co., Inc., Novartis, Pharmaceuticals, Pfizer Pharmaceuticals, Pharmacia Corporation, Solvay and Wyeth-Ayerst Pharmaceuticals. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance was utilized in the production of this manuscript. Writing assistance was provided by Frances Gambling, Medicus International. Editorial support was funded by Johnson & Johnson.